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Gonsalves DG, Raffa PEAZ, de Sousa GG, Rigueiral MEG, Estevão IA, Pacheco CC, Medeiros RTR, Franceschini PR, de Aguiar PHP. B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review. Asian J Neurosurg 2023; 18:231-245. [PMID: 37397032 PMCID: PMC10310451 DOI: 10.1055/s-0043-1768574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
Intramedullary tumors represent the major cause of spinal cord injuries, and its symptoms include pain and weakness. Progressive weakness may concomitantly occur in the upper and lower limbs, along with lack of balance, spine tenderness, sensory loss, trophic changes of extremity, hyperreflexia, and clonus. The study protocol was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search of the MEDLINE electronic database was performed to identify the studies reporting the clinical features of children and adults who presented with an intramedullary lymphoma. Twenty-one studies were included, reporting 25 cases. Manuscripts were excluded if the full-text article was not available, original data were not reported (e.g., review articles), or if the main disease was not intramedullary lymphoma. A structured data extraction form was employed to standardize the identification and retrieval of data from manuscripts. To enlighten the discussion, a case is also presented. An 82-year-old woman with Fitzpatrick skin type II, diagnosed and treated for non-Hodgkin's lymphoma 7 years ago, was admitted with mental confusion and memory loss for the past 2 months-evolving with recurring falls from her own height. One day before admission, she displayed Brown-Séquard syndrome. An expansive lesion from C2 to C4 in the cervical spinal cord was found and a hypersignal spinal cord adjacent was described at the bulb medullary transition to the C6-C7 level. A primary spinal cord tumor was considered, as well as a melanoma metastasis, due to the lesion's flame pattern. The patient presented a partial recovery of symptoms and a reduction of the spinal cord edema after being empirically treated with corticosteroids, but the lesion maintained its extent. Subsequently, a large diffuse B-cell lymphoma with nongerminal center was found in open body biopsy, infiltrating neural tissue. The main objective of the present study is to report a surgical case treated for a large diffuse B-cell lymphoma, in addition to presenting the results of a systematic review of primary intramedullary spinal cord lymphoma.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Paulo Henrique Pires de Aguiar
- Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil
- Department of Research and Innovation, Laboratory of Cellular and Molecular Biology, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil
- Department of Neurology, School of Medicine of Pontifical Catholic University of São Paulo, Sorocaba, São Paulo, Brazil
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Arçay A, Bural GG, Şenol U. Neurolymphomatosis with Spinal Nerve Root Involvement Demonstrated on 18F-FDG PET/CT. Mol Imaging Radionucl Ther 2022; 31:242-243. [PMID: 36268937 PMCID: PMC9585998 DOI: 10.4274/mirt.galenos.2021.05902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 56 years old woman with a diagnosis of diffuse large B-cell lymphoma had dyspnea, weakness in the left upper extremity and vocal cord paralysis after chemotherapy. She underwent cervical, thoracal and lumbosacral magnetic resonance imaging (MRI) however findings on MRI could not entirely explain the symptoms of the patient. Therefore, the patient underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography and the scan revealed focal symmetrical 18F-FDG uptake on the cervical, thoracal and lumbal spinal nerve roots. Considering the symptoms of the patient and cerebrospinal fluid cytology findings, hypermetabolic spinal nerve roots were interpreted as lymphoma involvement.
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Affiliation(s)
- Ayça Arçay
- Akdeniz University Faculty of Medicine, Department of Nuclear Medicine, Antalya, Turkey
| | - Gonca Gül Bural
- Akdeniz University Faculty of Medicine, Department of Nuclear Medicine, Antalya, Turkey
| | - Utku Şenol
- Akdeniz University Faculty of Medicine, Department of Radiology, Antalya, Turkey
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